Provider Demographics
NPI:1568521474
Name:BAUER, BRITTNEY M (PA-C)
Entity Type:Individual
Prefix:MS
First Name:BRITTNEY
Middle Name:M
Last Name:BAUER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:BRITTNEY
Other - Middle Name:M
Other - Last Name:KNISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2091 BOX BUTTE AVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:ALLIANCE
Mailing Address - State:NE
Mailing Address - Zip Code:69301-4452
Mailing Address - Country:US
Mailing Address - Phone:308-762-7244
Mailing Address - Fax:308-762-6657
Practice Address - Street 1:2091 BOX BUTTE AVE
Practice Address - Street 2:SUITE 700
Practice Address - City:ALLIANCE
Practice Address - State:NE
Practice Address - Zip Code:69301-4452
Practice Address - Country:US
Practice Address - Phone:308-762-7244
Practice Address - Fax:308-762-6657
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1138363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00203563OtherRR MEDICARE - HEMINGFORD
P00153655OtherRR MEDICARE - SFC
NE38753OtherBCBSNE
NE506729276Medicaid
NE506729276Medicaid
NE38753OtherBCBSNE
P00153655OtherRR MEDICARE - SFC
Q21564Medicare UPIN